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(652) Effect of Seroconversion after SARS-CoV-2 Vaccination on the Severity of COVID-19 Disease in Heart Transplant Recipients

PURPOSE: Heart transplant (HTX) recipients are prone to develop serious symptoms after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and their vaccination is often ineffective. In this high-volume single center study, we aimed to examine the seroconversion rates achieved wit...

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Autores principales: Kugler, S., Vári, D., Veres, D., Király, Á., Teszák, T., Parázs, N., Tarjányi, Z., Drobni, Z., Szakál-Tóth, Z., Prinz, G., Miheller, P., Merkely, B., Sax, B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Published by Elsevier Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10068088/
http://dx.doi.org/10.1016/j.healun.2023.02.666
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author Kugler, S.
Vári, D.
Veres, D.
Király, Á.
Teszák, T.
Parázs, N.
Tarjányi, Z.
Drobni, Z.
Szakál-Tóth, Z.
Prinz, G.
Miheller, P.
Merkely, B.
Sax, B.
author_facet Kugler, S.
Vári, D.
Veres, D.
Király, Á.
Teszák, T.
Parázs, N.
Tarjányi, Z.
Drobni, Z.
Szakál-Tóth, Z.
Prinz, G.
Miheller, P.
Merkely, B.
Sax, B.
author_sort Kugler, S.
collection PubMed
description PURPOSE: Heart transplant (HTX) recipients are prone to develop serious symptoms after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and their vaccination is often ineffective. In this high-volume single center study, we aimed to examine the seroconversion rates achieved with various types and doses of SARS-CoV-2 vaccines and assessed factors influencing vaccine immunogenicity and predictors of severe SARS-CoV-2 infection. METHODS: 229 HTX recipients were enrolled at a university clinic. Type of the first two doses of vaccine included mRNA, vector and inactivated vaccines as well. We carried out analyses on seroconversion after the second and third doses of vaccination and on severity of coronavirus disease 2019 (COVID-19). Anti-SARS-CoV-2 IgG levels were measured with Elecsys immunoassay (Roche). Effect of the first two vaccine doses was studied on patients who did not suffer SARS-CoV-2 infection before antibody measurement (n=175). Seroconversion after the third vaccine was analysed among seronegative patients after two doses (n=53). Predictors for severe infection defined as pneumonia, hospitalization or death was assessed in all HTX recipients who had COVID-19 (n=92). Logistic regression was applied for further analyses. RESULTS: 62% of the recipients became seropositive after the second vaccination. Longer time between HTX and vaccination (OR: 2.35, 95% CI: 1.28 - 4.49, p=0.007) and mRNA type of vaccine (OR: 4.83, 95% CI: 1.33 - 17.5, p=0.012) were predictors of seroconversion. 58% of the non-responsive patients became seropositive after receiving the third vaccine. Male sex increased the chance of IgG production after the third dose (OR: 5.65, 95% CI: 1.61 - 22.7, p=0.009). Clinical course of SARS-CoV-2 infection was severe in 32%. Of all parameters assessed, only seropositivity was proven to have a protective effect against severe infection (OR: 0.12, 95% CI: 0.02 - 0.64, p=0.019). CONCLUSION: Longer time since HTX, mRNA vaccine type and male sex promoted seroconversion after SARS-CoV-2 vaccination in HTX recipients. Seropositivity was proven to be protective against severe SARS-CoV-2 infection in single center cohort. Routine screening of HTX patients for anti-SARS-COV-2 antibodies may help to identify patients at risk for severe infection requiring addtional measures of anti-SARS-CoV-2 protection.
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spelling pubmed-100680882023-04-03 (652) Effect of Seroconversion after SARS-CoV-2 Vaccination on the Severity of COVID-19 Disease in Heart Transplant Recipients Kugler, S. Vári, D. Veres, D. Király, Á. Teszák, T. Parázs, N. Tarjányi, Z. Drobni, Z. Szakál-Tóth, Z. Prinz, G. Miheller, P. Merkely, B. Sax, B. J Heart Lung Transplant Article PURPOSE: Heart transplant (HTX) recipients are prone to develop serious symptoms after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and their vaccination is often ineffective. In this high-volume single center study, we aimed to examine the seroconversion rates achieved with various types and doses of SARS-CoV-2 vaccines and assessed factors influencing vaccine immunogenicity and predictors of severe SARS-CoV-2 infection. METHODS: 229 HTX recipients were enrolled at a university clinic. Type of the first two doses of vaccine included mRNA, vector and inactivated vaccines as well. We carried out analyses on seroconversion after the second and third doses of vaccination and on severity of coronavirus disease 2019 (COVID-19). Anti-SARS-CoV-2 IgG levels were measured with Elecsys immunoassay (Roche). Effect of the first two vaccine doses was studied on patients who did not suffer SARS-CoV-2 infection before antibody measurement (n=175). Seroconversion after the third vaccine was analysed among seronegative patients after two doses (n=53). Predictors for severe infection defined as pneumonia, hospitalization or death was assessed in all HTX recipients who had COVID-19 (n=92). Logistic regression was applied for further analyses. RESULTS: 62% of the recipients became seropositive after the second vaccination. Longer time between HTX and vaccination (OR: 2.35, 95% CI: 1.28 - 4.49, p=0.007) and mRNA type of vaccine (OR: 4.83, 95% CI: 1.33 - 17.5, p=0.012) were predictors of seroconversion. 58% of the non-responsive patients became seropositive after receiving the third vaccine. Male sex increased the chance of IgG production after the third dose (OR: 5.65, 95% CI: 1.61 - 22.7, p=0.009). Clinical course of SARS-CoV-2 infection was severe in 32%. Of all parameters assessed, only seropositivity was proven to have a protective effect against severe infection (OR: 0.12, 95% CI: 0.02 - 0.64, p=0.019). CONCLUSION: Longer time since HTX, mRNA vaccine type and male sex promoted seroconversion after SARS-CoV-2 vaccination in HTX recipients. Seropositivity was proven to be protective against severe SARS-CoV-2 infection in single center cohort. Routine screening of HTX patients for anti-SARS-COV-2 antibodies may help to identify patients at risk for severe infection requiring addtional measures of anti-SARS-CoV-2 protection. Published by Elsevier Inc. 2023-04 2023-04-03 /pmc/articles/PMC10068088/ http://dx.doi.org/10.1016/j.healun.2023.02.666 Text en Copyright © 2023 Published by Elsevier Inc. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Kugler, S.
Vári, D.
Veres, D.
Király, Á.
Teszák, T.
Parázs, N.
Tarjányi, Z.
Drobni, Z.
Szakál-Tóth, Z.
Prinz, G.
Miheller, P.
Merkely, B.
Sax, B.
(652) Effect of Seroconversion after SARS-CoV-2 Vaccination on the Severity of COVID-19 Disease in Heart Transplant Recipients
title (652) Effect of Seroconversion after SARS-CoV-2 Vaccination on the Severity of COVID-19 Disease in Heart Transplant Recipients
title_full (652) Effect of Seroconversion after SARS-CoV-2 Vaccination on the Severity of COVID-19 Disease in Heart Transplant Recipients
title_fullStr (652) Effect of Seroconversion after SARS-CoV-2 Vaccination on the Severity of COVID-19 Disease in Heart Transplant Recipients
title_full_unstemmed (652) Effect of Seroconversion after SARS-CoV-2 Vaccination on the Severity of COVID-19 Disease in Heart Transplant Recipients
title_short (652) Effect of Seroconversion after SARS-CoV-2 Vaccination on the Severity of COVID-19 Disease in Heart Transplant Recipients
title_sort (652) effect of seroconversion after sars-cov-2 vaccination on the severity of covid-19 disease in heart transplant recipients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10068088/
http://dx.doi.org/10.1016/j.healun.2023.02.666
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